Optometric Management Tip # 365   -   Wednesday, February 04, 2009
Practice Management Grand Rounds

Education in ocular disease management often takes the form of individual case reports in a grand rounds format, so I thought why not mimic that with practice management issues? From time to time, I'll present a real case, starting with a history and pertinent information and then I'll offer my thoughts on how to handle the current situation and how to manage it better for the future. You can certainly assist me with this approach by sending me your difficult case examples of challenges in areas such as patient service, staff management, practice finances, instrumentation, office design or other management topics.


Here is an interesting case a colleague recently asked me to comment on.

A patient purchased glasses from a low-price optical chain that advertises free eye exams and two pair of glasses for $69. She brought in a mangled pair of these glasses yesterday and asked my optician to straighten them. They broke. The frame had already been discontinued when it was sold. My optician tried to find a pair of frames to put her lenses into with no success.

Do you have a form for a patient to sign before doing anything with a frame purchased outside the office? How would you handle this from here?


From where you are now with this case, I'd invite the patient to select a similar frame from your lower priced lines or order her one from a catalog and place new lenses into the frame, matching the lens type from the broken glasses. After all, you broke her glasses, right?

I think it's important to not let situations like this aggravate you. It happens. Stay detached and unemotional and look at it from a business standpoint only. I'm all in favor of learning from events like this and trying to prevent them in the future, but don't make your optician feel too badly about it. This is an opportunity to show your staff that you are good boss and you understand what they have to deal with. By not chastising an employee who makes a mistake, you encourage all staff to be up front and open about future mistakes.

In an odd way, this unfortunate event is also an opportunity to show the patient that she's not dealing with a low-price chain when she is in your office. Taking care of problems with dignity and class speaks loudly about the kind of practice you have and people talk. You can win this patient and her circle of friends. Of course, if you or your staff tried to shift the blame and did not step up right away then you may lose the public relations value. I certainly wouldn't want to incur the remake expense and miss out on the good will value.

For the future, I would not use a disclaimer form for a frame adjustment but I would train staff to give the disclaimer verbally. When the optician is looking at a mangled frame that is not under your warranty, whether it was purchased from you or elsewhere, she should explain to the patient that the frame is badly damaged and not under warranty. Say something like: I'll do my very best to try to make this frame wearable again, but I can't guarantee it. It could break. Explain that the lenses will not likely fit into any other frame and this model may be discontinued, so the patient may have to just buy a new pair of glasses if it breaks. Then listen. If the patient says she understands and it is all right to proceed, then go ahead.

Signing forms for adjustments is just too cumbersome and bad for your image. I do use a disclaimer form when re-using a patient's own frame with the purchase of new lenses. I recommend that because the job is going out to a lab, which will take a few days and it will be handled by others. See Tip #11 for more information on that form.

Many readers will say the optician should not have adjusted the glasses in the first place and should have just sent the patient back to the optical chain store. That is one way to handle it and I wouldn't disagree with that approach, but we should acknowledge that it's very easy to be a Monday morning quarterback. In reality, in a busy office when a patient walks in with an eyeglass problem, the instinct is to just help him out. It's good service and I still believe that free adjustments are a great way to build future relationships.

A happy ending - this time

The optometrist sent me a follow-up message about his case. My optician is having the patient pick out a budget frame and having new lenses ground. The patient even ordered a supply of contact lenses. All is well.

Best wishes for continued success,

Neil B. Gailmard, OD, MBA, FAAO
Chief Optometric Editor, Optometric Management